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‣ Influence of decortication of the recipient graft bed on graft integration and tissue neoformation in the graft-recipient bed interface

CANTO, Fabiano R. T.; GARCIA, Sergio B.; ISSA, Joao P. M.; MARIN, Anderson; BEL, Elaine A. Del; DEFINO, Helton L. A.
Fonte: SPRINGER Publicador: SPRINGER
Tipo: Artigo de Revista Científica
Português
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The objective of the present study was to assess the influence of decortication of the posterior elements of the vertebra (recipient bed) and the nature of the bone graft (cortical or cancellous bone) on graft integration and bone, cartilage and fiber neoformation in the interface between the vertebral recipient bed and the bone graft. Seventy-two male Wistar rats were divided into four experimental groups according to the presence or absence of decortication of the posterior vertebral elements and the use of a cortical or cancellous bone graft. Group I-the posterior elements were decorticated and cancellous bone used. Group II-the posterior elements were decorticated and cortical graft was used. Group III-the posterior elements were not decorticated and cancellous graft was used. Group IV-the posterior elements were not decorticated and cortical graft was used. The animals were killed 3, 6 and 9 weeks after surgery and the interface between the posterior elements and the bone graft was subjected to histomorphometric evaluation. Mean percent neoformed bone was 40.8% in group I (decortication and cancellous graft), 39.13% in group II (decortication and cortical graft), 6.13% in group III (non-decorticated and cancellous graft), and 9.27% in group IV (non-decorticated and cortical graft) for animals killed at 3 weeks (P = 0.0005). For animals killed at 6 weeks...

‣ Corneal graft survival after therapeutic keratoplasty for Acanthamoeba keratitis

KASHIWABUCHI, Renata T.; FREITAS, Denise de; ALVARENGA, Lenio S.; VIEIRA, Luiz; CONTARINI, Patricia; SATO, Elcio; FORONDA, Annette; HOFLING-LIMA, Ana Luisa
Fonte: WILEY-BLACKWELL Publicador: WILEY-BLACKWELL
Tipo: Artigo de Revista Científica
Português
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Purpose: To describe corneal graft survival and visual outcome after therapeutic penetrating keratoplasty in patients with Acanthamoeba keratitis (AK) that is unresponsive to clinical treatment. Methods: Retrospective study. Thirty-two patients with AK who underwent therapeutic penetrating keratoplasty (tPK) from August 1996 to August 2005 were included. Data relating to clinical features, visual acuity, surgical technique, graft survival and complications were collected. Graft survival was evaluated by the Kaplan-Meier method and comparisons were performed using the Log-rank test. Results: Most patients (62.5%) were female. Mean age [+/- standard deviation (SD)] was 35 (+/- 13) years (range 15-68 years). All patients were contact lens wearers. Eighteen patients (56%) presented paralytic mydriasis and glaucoma during the treatment. Thirteen patients (40%) developed glaucoma after surgery; eight of them (61%) required a second PK because of graft failure. Of the 32 keratoplasty eyes, 56.2% presented graft failure at any follow-up point. Forty-five per cent of graft failures occurred before the 12 month follow-up, so 55% remained clear in the first year after surgery. Twelve patients underwent a second PK; seven of them failed and 45% were clear at 1 year. Two patients presented graft recurrence of amoebic infection. There was no significant difference in graft survival when eyes with or without mydriasis were compared (P = 0.40). Eyes with glaucoma presented a significantly shorter graft survival (P = 0.01). Conclusion: Penetrating keratoplasty is a treatment option for eyes that are unresponsive to clinical treatment infections. However...

‣ Enxerto córtico-esponjoso homógeno processado quimicamente e esterilizado em óxido de etileno, em cães: análise mecânica e estudo da integração por meio de radiografias.; Homogenous cortico-cancellous graft chemically prepared and sterilized in ethylene oxide, in dogs.

Castania, Vitor Aparecido
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 21/06/2002 Português
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O principal propósito da enxertia óssea é estimular a osteogênese, mas é útil que o enxerto apresente outras propriedades tais como a resistência mecânica, possibilidade de estocagem e de ser usado em diferentes quantidades. Nesta pesquisa nós estudamos algumas propriedades mecânicas e o desempenho biológico de uma amostra de enxerto ósseo homógeno quimicamente processado e esterilizado em óxido de etileno. Primeiramente, amostras cilíndricas de tal enxerto, foram ensaiadas mecanicamente em compressão. Em uma segunda instância, o enxerto foi implantado em cães adultos. Trinta animais foram divididos em dois grupos. No grupo I, dez cães receberam um bloco cilíndrico de osso homógeno quimicamente preparado que foi implantado num leito cilíndrico confeccionado na epífise distal do fêmur direito. Três semanas após, o mesmo animal foi submetido à mesma cirurgia, desta vez no fêmur esquerdo. Seis semanas após a primeira operação, o cão foi sacrificado. O grupo II consistiu de vinte cães que receberam um enxerto autógeno cilíndrico que foi obtido do fêmur esquerdo e implantado no fêmur direito, da mesma forma que no grupo I. Dez animais (subgrupo A) foram sacrificados três semanas após o implante e dez animais (subgrupo B) foram sacrificados seis semanas após o implante. Os animais foram acompanhados clinicamente...

‣ Enxerto corticoesponjoso homógeno processado quimicamente, esterilizado em óxido de etileno e embebido em medula óssea autógena. Estudo experimental em cães (Canis familiaris LINNAEUS, 1758); Homogenous cortical-cancellous bone graft chemically processed, sterilized with ethylene oxide and soaked in autogenous bone marrow. An experimental study in dogs (Canis familiaris LINNAEUS, 1758).

Castania, Vitor Aparecido
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 04/05/2007 Português
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Foi estudado experimentalmente o desempenho biológico de um tipo de enxerto ósseo homógeno, processado quimicamente, esterilizado em óxido de etileno e embebido em medula óssea autógena. De cães doadores adulto-jovens foram obtidos blocos cilíndricos de 1,0 x 1,0 cm da epífise distal do fêmur, com auxílio de uma trefina. Os ossos assim obtidos foram clareados, desengordurados, esterilizados em óxido de etileno e mantidos em estoque. Trinta cães adultos jovens foram usados como receptores do enxerto e foram alocados em dois grupos. No grupo I (experimental) os animais foram operados e, criado, transversalmente, com trefina de 1,0 cm de diâmetro externo, um espaço cilíndrico de 1,0 cm de diâmetro por 1,0 cm de altura na epífise distal do fêmur direito, onde foi encaixado o enxerto preparado e que foi previamente embebido em medula óssea do próprio animal retirada por punção óssea na crista ilíaca. Três semanas depois, o mesmo animal foi submetido ao mesmo procedimento cirúrgico no fêmur esquerdo. Os cães deste grupo foram sacrificados seis semanas após a primeira cirurgia. O grupo II constituiu o controle e foi formado por vinte cães adulto-jovens em que, primeiro, foi retirado um cilindro de osso da epífise distal do fêmur esquerdo e...

‣ Influência da decorticação na neoformação tecidual da interface do enxerto ósseo na coluna vertebral; Decortication influence in the new tissue formation in the bone graft interface in the spine.

Canto, Fabiano Ricardo de Tavares
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 23/10/2007 Português
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Foi realizado estudo experimental para determinar a influência da decorticação dos elementos posteriores da coluna vertebral na integração do enxerto ósseo autólogo esponjoso ou cortical, considerando a avaliação histológica quantitativa e qualitativa dos tecidos (ósseo, cartilaginoso e fibroso) presentes na interface entre o leito receptor e o enxerto ósseo. Setenta e dois ratos Wistar foram divididos em quatro grupos experimentais: grupo I_ leito posterior decorticado enxerto esponjoso, grupo II_ leito posterior decorticado enxerto cortical, grupo III_ leito posterior não decorticado enxerto esponjoso, grupo IV_ leito posterior não decorticado enxerto cortical. Os quatro grupos experimentais foram sacrificados com 3, 6 e 9 semanas de pós-operatório e a região operada foi submetida a avaliação histológica e histomorfométrica. Nos animais sacrificados com 3 semanas de pós-operatório a média da porcentagem de osso neoformado no grupo I foi de 40,87%±5,24, no grupo II de 39,13%±7,27, no grupo III de 6,13%±2,13, no grupo IV de 9,27%±4,06. Foi observada diferença estatística entre os valores da neoformação óssea (p=0,0005). A média da porcentagem de tecido cartilaginoso neoformado no grupo I foi de 8,36%±1...

‣ Imunolocalização do fator de crescimento BMP-2 em enxerto ósseo autógeno em bloco recoberto ou não por membrana de PTFE-e; Immunolocalization of BMP-2 growth factor in autogenous block graft covered or not with an e-PTFE membrane

Marco, Andrea Carvalho de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 18/02/2008 Português
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O objetivo deste estudo foi avaliar a imunolocalização do fator de crescimento BMP- 2 em enxerto ósseo autógeno em bloco recoberto ou não por membrana de PTFE-e na fase inicial da reparação óssea. MATERIAL E MÉTODOS: Quarenta e oito ratos "wistar" foram divididos em dois grupos de estudo, um que recebeu somente o enxerto ósseo autógeno (E) e o outro que recebeu o enxerto ósseo autógeno recoberto por membrana (ME). Os períodos de avaliação foram: 0 hora, 3, 7, 14, 21 e 45 dias. Os cortes foram submetidos à reação imunoistoquímica. Foram realizadas as análises, qualitativa e quantitativa: contagem de células com marcação intracitoplasmática nas estruturas bordo, enxerto, tecido conjuntivo superior ao enxerto, interface e leito. RESULTADOS: No leito o maior número de células marcadas foi observado em 3 dias nos grupos (E) e (ME). A região de bordo apresentou maior número de células marcadas em 7 dias no grupo (E) e em 14 dias no grupo (ME), onde a marcação foi predominante em osteoblastos e células osteoprogenitoras em áreas de remodelação óssea. No tecido conjuntivo superior ao enxerto a maior proporção de marcação no grupo (E) ocorreu em 7 dias e no grupo (ME) em 21 dias, no entanto, neste último...

‣ Hipernatremia do doador como fator de risco para falência primária de enxerto após transplante cardíaco ortotópico; Hypernatremia of donor as a risk factor for primary graft failure after heart transplantation

Finger, Marco Aurelio
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 09/04/2013 Português
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Introdução: O transplante cardíaco exerce um papel relevante no tratamento da insuficiência cardíaca grave. Dentro dos desfechos desfavoráveis a seus resultados, a falência primária do enxerto é reconhecida, como condição de gravidade e mortalidade elevada. Os fatores implicados no aparecimento da falência primária do enxerto ainda não são bem esclarecidos e sua relevância é pouco estudada. Objetivo: Observar se há associação entre hipernatremia do doador e de outras variáveis com o desenvolvimento da falência primária do enxerto (FPE). Métodos: Foram avaliados, retrospectivamente, 200 pacientes submetidos à cirurgia de Transplante Cardíaco Ortotópico (TxC) no Instituto Dante Pazzanese de Cardiologia (IDPC), no período entre 01/01/2001 e 31/12/2010, sendo cotado os níveis de sódio sérico no doador. Além disto, foram avaliados outros fatores relacionados ao doador, ao receptor e ao procedimento cirúrgico. Após a identificação de que o sódio sérico do doador estava elevado no grupo de receptores com FPE, um ponto de corte foi obtido pela curva ROC. O nível de significância dos testes foi de 5%. Um modelo de regressão logística múltipla foi ajustado para avaliar os efeitos de fatores e covariáveis presentes na FPE. Resultados: Entre os pacientes que desenvolveram falência primária do enxerto...

‣ Análise da expressão de neurotrofinas durante a regeneração de nervo periférico de rato por enxerto venoso; Analysis of the expression of neurotrophins during regeneration of peripheral nerves in rats with vein graft

Ahmed, Farooque Jamaluddin
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 15/02/2013 Português
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Análise da expressão de neurotrofinas durante a regeneração de nervo periférico de rato por enxerto venoso Enxertos de veias têm sido empregados para preencher lacunas em nervos periféricos transeccionados para melhor recuperação funcional. No entanto, vários inconvenientes, como a constrição do enxerto secundário foram observados. Uma nova alternativa para esta técnica foi desenvolvida. Simplesmente invertendo a veia de dentro para fora, chamado do Inside- out vein graft. As neurotrofinas são uma família de fatores neurotróficos conhecidos por desempenhar um papel significativo na regeneração de nervos periféricos. A família da neurotrofina é constituído por fator de crescimento nervoso (NGF), fator neurotrófico derivado do cérebro (BDNF), Neurotrofina-3 (NT-3) e Neurotrofina-4 (NT-4). No campo da neurobiologia, vários autores têm utilizado a técnica de PCR a fim de obter mais informações sobre os nervos regenerados. Neste estudo, foi utilizada a técnica de biologia molecular para explorar o papel e o nível das neurotrofinas durante a regeneração de nervos periféricos com enxerto de veia. O nervo isquiático de ratos foi seccionado e reparado com enxerto de veia invertida (IOVG) e técnicas de enxerto de veia padrão (SVG). No grupo controle...

‣ Glutaraldehyde-treated homologous vein graft as a vein substitute: experimental study in rabbits

Moura, R.; Maffei, Francisco Humberto de Abreu; Mattar, L.; Fabris, V. E.; Cury, P.; Lastoria, S.; Gregorio, E. A.
Fonte: Edizioni Minerva Medica Publicador: Edizioni Minerva Medica
Tipo: Artigo de Revista Científica Formato: 113-119
Português
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Aim. Vein reconstruction using grafts may prevent sequelae of venous interruption or lesion. Autologous vein is sometimes unsuitable or absent for a vascular restoration. The aim of this study was to study glutaraldehyde-treated homologous vein graft as vein substitute and compare it with autologous vein as a substitute for a vena cava segment in rabbits.Methods. Sixty rabbits were allocated into two groups: autologous vein graft (AG), and glutaraldehyde-treated homologous vein graft (HG). Each group was subdivided into three subgroups (N.=10) to be studied at: 24 hours, 14 days, and 28 days. The veins were treated in 0.19% glutaraldehyde, pH=7.4, for 1 hour and kept at 4 degrees C in saline with added gentamicin and amphotericin B. The animals received benzanthine penicillin on the day of graft implantation and heparin only during surgery. The grafts were implanted into the vena cava. Anastomosis was performed with interrupted sutures. Cavography was performed, after surgery, and at the time the animals were killed. Evaluation of the veins was made macroscopically and by light and scanning electron microscopy.Results. Fibrosis was seen around the grafts at 14 and 28 days...

‣ Inside-out vs. standard vein graft to repair a sensory nerve in rats

Ferrari, Fábio; De Rodrigues, Antonio Castro; Malvezzi, Cristiane Karina; Silva, Maeli Dal Pai; Padovani, Carlos Roberto
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 227-232
Português
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Nerve regeneration in a sensory nerve was obtained by the application of different techniques: inside-out vein graft (IOVG group) and standard vein graft (SVG group). These techniques provide a good microenvironment for axon regeneration in motor nerves, but their efficiency for regeneration of sensory nerves is controversial. The saphenous nerve was sectioned and repaired by the inside-out and standard vein graft techniques in rats. After 4, 12, and 20 weeks the graft and the distal stump were observed under electron microscopy. In each studied period, the pattern, diameters, and thickness of the myelin sheaths of the regenerated axons were measured in the graft and distal stump. A comparative study about the regenerated nerve fibers by these two different techniques was performed. Regenerated nerve fibers were prominent in both vein grafts 4 weeks after the surgical procedures. On the other hand, in the distal stump, regenerated nerve fibers were observed only from 12 weeks. In both inside-out vein graft and standard vein graft statistical difference was not observed about the diameters and thickness of the myelinated fibers after 20 weeks. On the other hand, the inside-out group had greater regenerated axon number when compared to the standard group. There is a capillary invasion in both graft and distal stump...

‣ Anemia at one year is an independent risk factor of graft survival

De Andrade, Luís Gustavo Modelli; Abrão, Juliana Maria Gera; Carvalho, Maria Fernanda Cordeiro
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 263-268
Português
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Background Post-transplant anemia is multifactorial and highly prevalent. Some studies have associated anemia with mortality and graft failure. The purpose of this study was to assess whether the presence of anemia at 1 year is an independent risk factor of mortality and graft survival. Methods All patients transplanted at a single center who survived at least 1 year after transplantation and showed no graft loss (n = 214) were included. Demographic and clinical data were collected at baseline and at 1 year. Patients were divided into two groups (anemic and nonanemic) based on the presence of anemia (hemoglobin<130 g/l in men and 120 g/l in women). Results Baseline characteristics such as age, gender, type of donor, CKD etiology, rejection, andmismatches were similar in both groups. Creatinine clearance was similar in both anemic and nonanemic groups (69.32 ± 29.8 × 75.69 ± 30.5 ml/mim; P = 0.17). A Kaplan- Meier plot showed significantly poorer death-censored graft survival in the anemic group, P = 0.003. Multivariate analysis revealed that anemic patients had a hazard ratio for the graft loss of 3.85 (95% CI: 1.49-9.96; P = 0.005). Conclusions In this study, anemia at 1 year was independently associated with death-censored graft survival and anemic patients were 3.8-fold more likely to lose the graft. © 2010 Springer Science+Business Media...

‣ Predictive factors of early graft loss in living donor liver transplantation

Alves,Rogério Camargo Pinheiro; Fonseca,Eduardo Antunes da; Mattos,Carla Adriana Loureiro de; Abdalla,Sofia; Gonçalves,José Eduardo; Waisberg,Jaques
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2012 Português
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CONTEXT: Living donor liver transplantation has become an alternative to reduce the lack of organ donation. OBJECTIVE: To identify factors predictive of early graft loss in the first 3 months after living donor liver transplantation. METHODS: Seventy-eight adults submitted to living donor liver transplantation were divided into group I with 62 (79.5%) patients with graft survival longer than 3 months, and group II with 16 (20.5%) patients who died and/or showed graft failure within 3 months after liver transplantation. The variables analyzed were gender, age, etiology of liver disease, Child-Pugh classification, model of end-stage liver disease (MELD score), pretransplantation serum sodium level, and graft weight-to-recipient body weight (GRBW) ratio. The GRBW ratio was categorized into < 0.8 and MELD score into >18. The chi-square test, Student t-test and uni- and multivariate analysis were used for the evaluation of risk factors for early graft loss. RESULTS: MELD score <18 (P<0.001) and serum sodium level > 135 mEq/L (P = 0.03) were higher in group II than in group I. In the multivariate analysis MELD scores > 18 (P<0.001) and GRBW ratios < 0.8 (P<0.04) were significant. CONCLUSIONS: MELD scores >18 and GRBW < 0.8 ratios are associated with higher probability of graft failure after living donor liver transplantation.

‣ Effect of fibrin glue derived from snake venom on the viability of autogenous split-thickness skin graft

Rahal,S.C.; Amaral,M.S.P.; Pai,V.D.; Barraviera,S.R.C.S.; Caporal,E.H.G; Crocci,A.J.
Fonte: Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP Publicador: Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2004 Português
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The aim of this study was to analyze the effect of snake venom derived from fibrin glue on the viability of split-thickness skin graft. Nine crossbreed dogs were used. Full-thickness skin segments measuring 4 x 4 cm were bilaterally excised from the proximal radial area on each dog. A split-thickness skin graft was harvestedfrom left lateral thoracic area using a freehand graft knife, and was secured to the left recipient bed using several simple interrupted sutures of 3-0 nylon (sutured graft). A split-thickness skin graft was harvested from the right lateral thoracic area using a graft knife. Fibrin glue derived from snake venom was applied to the recipient bed, and 8 equidistant simple interrupted sutures of 3-0 nylon were used to secure the skin graft (glued graft). Viable and nonviable areas were traced on a transparent sheet and measured using a Nikon Photomicroscope connected to a KS-300 image analysis system. The skin graft and recipient bed were collected from three dogs at day 7, 15, and 30 postoperative. The glued grafts had statistically higher graft viability than sutured grafts. Histological examination showed that the tissue repair process in the glued grafts was more accentuated than sutured grafts. It was possible to conclude that fibrin glue derived from snake venom increased survival of autogenous split-thickness skin graft.

‣ Correction of Short Nose Deformity Using a Septal Extension Graft Combined with a Derotation Graft

Paik, Moo Hyun; Chu, Lo Shui
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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In patients having a short nose with a short septal length and/or severe columellar retraction, a septal extension graft is a good solution, as it allows the dome to move caudally and pushes down the columellar base. Fixing the medial crura of the alar cartilages to a septal extension graft leads to an uncomfortably rigid nasal tip and columella, and results in unnatural facial animation. Further, because of the relatively small and weak septal cartilage in the East Asian population, undercorrection of a short nose is not uncommon. To overcome these shortcomings, we have used the septal extension graft combined with a derotation graft. Among 113 patients who underwent the combined procedure, 82 patients had a short nose deformity alone; the remaining 31 patients had a short nose with columellar retraction. Thirty-two patients complained of nasal tip stiffness caused by a septal extension graft from previous operations. In addition to the septal extension graft, a derotation graft was used for bridging the gap between the alar cartilages and the septal extension graft for tip lengthening. Satisfactory results were obtained in 102 (90%) patients. Eleven (10%) patients required revision surgery. This combination method is a good surgical option for patients who have a short nose with small septal cartilages and do not have sufficient cartilage for tip lengthening by using a septal extension graft alone. It can also overcome the postoperative nasal tip rigidity of a septal extension graft.

‣ A new model of orthotopic penetrating corneal transplantation in the sheep: Graft survival, phenotypes of graft-infiltrating cells and local cytokine production

Williams, K.; Standfield, S.; Mills, R.; Takano, T.; Larkin, D.; Krishnan, R.; Russ, G.; Coster, D.
Fonte: BLACKWELL SCIENCE ASIA Publicador: BLACKWELL SCIENCE ASIA
Tipo: Artigo de Revista Científica
Publicado em //1999 Português
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BACKGROUND: Orthotopic penetrating keratoplasty in the sheep was developed as an outbred preclinical model to allow correlation of the cellular infiltrate during graft rejection with local production of cytokine mRNA. METHODS: Penetrating corneal autografts and allografts were performed in Merino sheep. Graft outcome was followed at the slit-lamp. Corneal infiltrates were examined by immunoperoxidase staining on postmortem specimens. Cytokine mRNA was detected by polymerase chain reaction. RESULTS: Corneal autografts survived indefinitely. Allografts became vascularized and underwent rejection at a median of 20 days postgraft. Both endothelial and epithelial rejection lines were observed. Immunohistochemical staining of rejecting grafts showed up-regulation of major histocompatibility complex class I molecules on corneal graft epithelium, damaged or absent graft endothelium and a marked, predominantly mononuclear cell infiltrate. CD4-positive T cells were observed in the graft within 2 days of the onset of rejection, followed several days later by CD8-positive T cells. Messenger RNA transcripts for interleukin (IL)-2, tumour necrosis factor (TNF)-alpha and IL-10 (but not for interferon (IFN)-gamma or IL-4) were found in autografted corneas. Proportionately...

‣ Interleukin-2 receptor antibody reduces rejection rates and graft loss in live-donor kidney transplant recipients

Lim, W.; Chang, S.; Chadban, S.; Campbell, S.; Dent, H.; Russ, G.; McDonald, S.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
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Background. The use of interleukin-2 receptor antibody (IL-2Ra) induction has been associated with reduced rejection rates in both live and deceased donor kidney transplantation. However, the longer term effect of IL-2Ra induction on estimated glomerular filtration rates and graft and patient survival remains unclear. Methods. Using Australia and New Zealand Dialysis and Transplant Registry, live donor renal transplant recipients in Australia between 2001 and 2005 were studied (n=1106). Multiple organ graft recipients and those receiving T-cell depletive induction therapy or steroid- or calcineurin-free inhibitor regimens were excluded. Outcomes analyzed included the presence of rejection at 6 months, estimated glomerular filtration rate at 1 and 3 years, 5 years graft and patient survival. Results. A total of 41.7% of live donor renal transplant recipients received IL-2Ra induction. Recipients of IL-2Ra experienced a 51% reduction in the incidence of acute rejection (odds ratio 0.49, 95%CI 0.36-0.67; P<0.001). In addition, the use of IL-2Ra was associated with reduced overall graft loss (hazard ratio 0.58, 95%CI 0.35-0.96; P=0.03) and higher mean estimated glomerular filtration rate at 1 year but not 3 years. There was no association between IL-2Ra induction and death-censored graft loss or death with functioning graft. Conclusion. This registry analysis demonstrates that IL-2Ra induction in live donor kidney transplantation is associated with substantial clinical benefits of reduced risk of acute rejection...

‣ Donor-recipient age matching improves years of graft function in deceased-donor kidney transplantation

Lim, W.; Chang, S.; Campbell, S.; Dent, H.; Russ, G.; McDonald, S.; Chadban, S.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
Relevância na Pesquisa
36.78708%
BACKGROUND. Donor and recipient age in kidney transplantation are known to affect graft and patient survival. In deceased-donor (DD) transplantation, donor and recipient age matching are being increasingly accepted as part of the kidney allocation programme. The aims of this study are to evaluate the effect of donor and recipient age on transplant outcomes and to determine the effect of changing existing allocation criteria to allocation based on age matching of donors and recipients on total graft years of function. METHODS. Using the Australia and New Zealand Dialysis and Transplant Registry, all DD kidney transplant recipients in Australia and New Zealand between 1991 and 2006 were analysed (n = 4616). Outcomes analysed were overall graft failure, death with functioning graft and serum creatinine. We calculated the mean time to graft loss (‘years of graft function’) for donor and recipient age cut-offs as 60 and 55 years, respectively, over up to 16 years follow-up. We then examined the gain in graft years if all older kidneys were allocated to older recipients. RESULTS. Older donors were associated with higher risk of overall graft failure [adjusted hazard ratio (HR) = 1.79, 95% confidence interval (95% CI) = 1.45, 2.21 and HR = 1.29...

‣ Retrospektive Studie zur Effizienz einer UV-Phototherapie bei kutaner Graft-versus-host Disease nach Stammzelltransplantation; Retrospective study on efficiency of UV phototherapy in cutaneous graft-versus-host disease after stem cell transplantation

Höhne, Sabine
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
Relevância na Pesquisa
36.799663%
Bei der akuten und chronischen Graft-versus-Host Disease der Haut handelt es sich um eine schwere Komplikation nach allogener Stammzelltransplantation von HLA-identischen Geschwisterspendern und von HLA-differenten nichtverwandten Spendern. Beide Formen der Graft-versus-Host Disease können zum jetzigen Zeitpunkt nur symptomatisch behandelt werden. In dieser retrospektiven, nicht randomisierten Studie wurden insgesamt 27 Patienten mit einer akuten oder chronischen Graft-versus-Host Disease nach allogener Stammzelltransplantation untersucht. Wir führten bei diesen 27 Patienten eine Photo(chemo)therapie mit verschiedenen Wellenlängen durch. Abhängig vom klinischen Hautbefund konnten wir bei einigen Patienten eine Reduktion der systemischen Immunsuppression durchführen. Insgesamt zeigte sich, dass alle Therapiemodalitäten (systemische PUVA-Phototherapie, topische PUVA-Phototherapie, UVA-1 Phototherapie sowie UVB-311 Phototherapie) bei der akuten Form der Graft-versus-Host Disease ein besseres Ansprechverhalten zeigten als die chronische Form der Graft-versus-Host Disease. Besonders deutlich wird in unserer Studie, dass vor allem die systemische PUVA-Phototherapie zu einer deutlichen Verbesserung der akuten Graft-versus-Host Disease führt...

‣ Intramural stresses at the distal graft/artery junction following femoral artery bypass surgery

O'Donnell, Michael R.
Fonte: University of Limerick Publicador: University of Limerick
Tipo: Doctoral thesis; all_ul_research; ul_published_reviewed; ul_theses_dissertations; none
Português
Relevância na Pesquisa
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peer-reviewed; Intimal hyperplasia development in the downstream anastomosis of a peripheral bypass grafts has been the subject of much investigation due to its site specific focal development at specific sites within the junction. Compliance mismatch between the synthetic graft and host artery is seen as a major cause of intimal hyperplasia formation along the suture line of synthetic graft/host artery anastomoses, with wall stress, wall shear stress, and local mass transport also playing an important role in intimal hyperplasia formation. The majority of previously published computational and experimental analyses focus on flow dynamics and the distribution of wall shear stress at distal End-To-Side bypass anastomoses. Studies associated with anastomotic mechanics and associated wall stress have reported abnormal wall stress at graft/artery anastomoses associated over excessive response by arterial tissue to the aforementioned stresses may correlate to intimal hyperplasia formation at anastomotic sites. The aim of this study is to further investigate abnormal wall stresses at the synthetic graft/artery anastomoses and to correlate abnormal wall stresses to sites of intimal hyperplasia formation at the distal End-To-Side anastomosis of the femoropopliteal system. To this end...

‣ Impact of immunosuppression treatment on the improvement in graft survival after deceased donor renal transplantation: a long-term cohort study

González-Molina,Miguel; Burgos,Dolores; Cabello,Mercedes; Ruiz-Esteban,Pedro; Rodríguez,Manuel A.; Gutiérrez,Cristina; López,Verónica; Baena,Víctor; Hernández,Domingo
Fonte: Nefrología (Madrid) Publicador: Nefrología (Madrid)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2014 Português
Relevância na Pesquisa
36.772432%
We analyzed graft half-life and attrition rates in 1045 adult deceased donor kidney transplants from 1986-2001, with follow-up to 2011, grouped in two periods (1986-95 vs. 1996-01) according to immunosuppression. The Kaplan-Meier curve showed a significant increase in graft survival during 1996-2001. The uncensored real graft half-life was 10.25 years in 1986-95 and the actuarial was 14.58 years in 1996-2001 (P<0.001). The attrition rates showed a significantly greater graft loss in 1986-95, even excluding the first year from the analysis. The decline in renal function was significantly less pronounced in 1996-2001, indicating better preservation of renal function, despite the increase in donor age and stroke as the cause of donor death. The parsimonious Cox multivariate model showed donor age, acute rejection, panel reactive antibody, cold ischemia time and delayed graft function were significantly associated with a higher risk of graft loss. In contrast, the risk of graft loss fell by 21% in 1996-2001 compared with 1986-95. A similar reduction (25%) was observed when MMF treatment was entered into the multivariate model instead of study period. Long-term graft survival improved significantly in 1996-2001 compared to 1986-1995 despite older donor age. Modern immunosuppression could have contributed to the improved kidney transplant outcome.